Impact of spinal injury on the course of the traumatic process in patients with combined thoracic trauma

S.O. Guriev, S.P. Satsyk, Yu.V. Reznichenko, V.A. Kushnir

Abstract

Background.The main features of the injury today are the increasing number and proportion of combined trauma, as well as increasing severity of combined traumatic injuries. The vertebra thoracic trauma is one of the varieties of combined trauma. The purpose of the study is to examine the impact of spinal injury on the course of the traumatic process in patients with combined thoracic trauma. Materials and methods.The comparison of the two groups of patients with combined thoracic trauma: the first one — 157 cases with the presence of vertebral component and the second one — 157 cases without it. The groups were formed on the basis of standardized indicators of the severity of the injury — Injury Severity Score (ISS). Results. It was found that the spine damage has probable influence on the course of the traumatic process, especially in patients with trauma severity of 35 points on an ISS scale. Various clinical and anatomical forms of spine damage have different, in terms of the intensity and outcome, effect of the course of the traumatic process. The strongest negative impact have cervical spine damage in the form of multiple vertebrae damage and fracture, as well as any damage, which belongs to type C according to the classification of Association for Osteosynthesis/Association for the Study of Internal Fixation, or damage that caused disruption of motor and sensory functions according to Frankel A and Frankel В qualification type. Conclusions. The spine damage has extremely negative influence on the course and outcome of traumatic process in patients with combined thoracic trauma. This is due to both the nature and severity of the spine damage, and to the impact of this damage on the other components of combined trauma. The above should be considered in the formation and implementation of clinical and organizational solutions to provide medical assistance to the patients with thoracic vertebral trauma.